Whether it’s in the news or our personal lives, we bear witness to people continuing to engage in compulsive, self-defeating behaviors despite the obvious negative or destructive effects. Sometimes it seems like what’s needed is more willpower, moral fiber, or a better strategy to fight temptation when the primitive part of our brains take over. However, in many cases the obstacle to change is that we were never fully on board with giving up these patterns in the first place. But why wouldn’t people who seem to, or should, “know better” be motivated to stop doing something that goes against themselves or hurts people they love?

David, 40, a renowned surgeon was a kind, good-natured, man. He had trouble trusting people close to him, which he related to his childhood and not being able to count on anyone. Like his dad, David had numerous extramarital affairs - even though he loved his wife and family and had been so hurt by his dad’s affair and abandonment. His wife discovered one of his affairs some years ago, and it nearly destroyed her and their marriage. When he thought about it he alternated between feeling shame and guilt and blaming his wife. David finally sought therapy because he felt unhappy, empty and depressed.

Though he wasn’t involved in affair at that time, he was attempting to contact a woman who had ended a previous affair with him. At first David said the problem was that he wasn’t capable of stopping these behaviors. But later he struggled about what the goal of therapy should be - seeming oppositional when considering working towards abstaining from affairs and behaviors leading to them. On the one hand, David idealized and defended his affairs, but when faced with what he did and how it affected his family, he felt terrible and saw himself as a bad person. He cared about how he treated people, especially those he loved.

In one session David talked about a movie he’d recently seen that had a profound effect on him. He identified with a character at the end of his life facing regret and emptiness about how he’d lived it. He feared this would be him, but talked about this in a curiously detached and fatalistic way.

Diagnosing the problem and assessing motivation

David had said it would be hopeless for him to try to stop having affairs because he couldn’t. However, before embarking on helping him with strategies to resist temptation, it was important to determine whether this was the relevant issue, or whether the first problem was actually motivational. “If I could give you a pill right now that would instantly give you the ability to stop being involved with other women, would you take it?” his therapist asked. David said he couldn’t commit to that. In fact, he had not made a decision to work towards giving up his habit. Had he said, “Yes” the next question would be, “Why - what are the top two reasons you want to stop being involved with other women?” Challenging people to articulate their reasons for wanting to break a habit establishes the internally driven, authentic motivation needed later for leverage when navigating change.

People caught in self-destructive dynamics need multidimensional help: understanding the function of these behaviors, learning strategies to deal with the underlying forces driving them, using alternate coping strategies, and developing presence of mind. But without a commitment to work towards giving up acting out, progress on the other issues would be undermined.

David appeared to recognize that his “acting out” was hurting him and the people he most wanted to protect. But then why didn’t he want to stop? A popular answer would be: moral weakness, narcissism or selfishness but, if that were the case, David wouldn’t see himself as bad and suffer so much guilt and remorse.

What explains David’s lack of motivation and fatalistic attitude about change?

Motivational Obstacles: Lack of awareness

Though David seemed aware of what he was doing and the consequences, being compartmentalized detached him from his values, feelings, and the feelings of those he loved. With this disconnect, he knew the facts but in a way that did not feel real. More importantly, he wasn’t anchored to the adult, evolved part of himself that held the values that gave his life meaning. It is this sense of ourselves in perspective through time that, like a lighthouse, guide us to resist temptation and follow a path that protects what matters and who we want to be.

Compartmentalization as an accomplice

Compartmentalization is a psychological defense that involves walling off aspects of ourselves and feelings to avoid pain and/or internal conflict. It involves a form of pretending in which information is temporarily banished from consciousness, in effect simplifying our experience. This strategy can be used intentionally to avoid distraction and emotional interference, allowing us to stay on task. But, when automatic, being walled off from feelings and aspects of ourselves can enable self-deception and lead to emotionally blind betrayal of ourselves and others. In this way, compartmentalization can play the role of enabler and accomplice in self-sabotaging patterns.

Interpersonally, David’s mind was stuck on one channel. With compartmentalization at play, it’s as if parts of the brain are offline - reducing breadth of awareness and constricting how the mind and brain functions. Detached from his values, with no lighthouse in sight, David betrayed himself and the people he loved, resulting in deep emptiness and shame. These symptoms were a visceral signal from inside himself that he was doing something wrong but, disconnected from the narrative of what they meant, David did not heed the warning.

Forces underlying self-destructive compulsive behaviors:

Shame

Compulsive self-destructive behavior patterns like David’s can be propelled unconsciously by an internalized sense of badness common in childhood emotional neglect, abuse or abandonment. When these feelings are acted upon by doing something “bad”, a self-fulfilling prophesy ensues - making real what had been a feeling sense - catapulting people back into the inner world of the past. Shame and guilt are intensified, along with the need for relief through immediate escape, leading to a cycle of self-destructive acting out. At the same time, accumulating evidence of “badness” resonates in a satisfying way with a haunting but intangible self-perception, further reinforcing temptation. This is what happened to David. Losing sight of the goodness in him, which included caring about how he treated people and protecting his family, David behaved accordingly.

Difficulty regulating feelings/mood

In addition, compulsive self-destructive behaviors, like other addictive symptoms, are often instigated in an attempt to ward off painful states such as depression, emptiness and isolation in the absence of other ways of coping. Caught in a familiar state of aloneness and, unhinged from any positive view of himself in relationship to others, David was overtaken by a familiar instinct to escape. High risk, stimulating behaviors provide a rush powerful enough to overwrite unbearable feelings, offering rapid transport into another state of mind, and [false] security or validation. But this respite is followed by feeling demoralized and out of control - leading to an insidious deterioration of mood, mental state and family life.

Summary

Shame and emotional dysregulation are forces that drive self-destructive behavior, but compartmentalization allows it to continue. Gaps in awareness caused by compartmentalization can allow self -destructive agendas to operate in their own orbit and spiral out of control. David stopped acting out and engaged in therapy when he became connected to what he was doing and it became real to him. Keeping David’s whole mind in sight and avoiding a parallel compartmentalized view of him, the therapist recognized that if he were fully present with himself he would not want to be out of control and blow up his life. The therapist activated David’s motivation by accepting what he was doing, refraining from struggling to convince him to stop, and helping him “own” in a more integrated and emotionally real way, without escape, how his behavior would play out. Once this happened, he became fearful and the part of him that knew what he had to lose, and cared, had a chance to come to the rescue before it was too late.

Disconnection from wisdom and perspective prevents the experience of conflict that motivates us to have restraint when tempted to violate what we hold precious. Without this grounding, fantasy can lead the way - divorcing us from reality and tricking us into a false sense of how good we will feel and the illusion that we can act out with impunity.

Disclaimer: The characters from this vignette are fictitious. They were derived from a composite of people and events.